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Home My WebLink AboutR-98-0495J-98-465 4/27/98 RESOLUTION NO. 9 8- 495 A RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE A PROFESSIONAL SERVICES AGREEMENT, IN A FORM ACCEPTABLE TO THE CITY ATTORNEY, WITH FOUNDATION HEALTH SYSTEMS, TO PROVIDE HEALTH INSURANCE COVERAGE FOR THE EMPLOYEES OF THE OFFICE OF HOMELESS PROGRAMS, FOR A PERIOD OF ONE (1) YEAR, WITH THE OPTION TO EXTEND FOR AN ADDITIONAL ONE (1) YEAR PERIOD, IN AN ANNUAL AMOUNT NOT TO EXCEED $45,000; ALLOCATING FUNDS THEREFOR FROM THE EMERGENCY SHELTER GRANT, ACCOUNT CODE 183011.450392.6.130 WHEREAS, the City of Miami Office of Homeless Programs (OHP) is part of a multi -agency team that provides outreach, assessment and placement to homeless individuals and families throughout Miami -Dade County; and is funded by U.S. HUD; and WHEREAS, during the grant period of June, 1996 through May 1997, the Office of Homeless Programs placed in shelters two thousand, nine hundred, ninety-one (2,991) homeless individuals and families who became homeless within the City of Miami's jurisdiction; and WHEREAS, the success of the Office of Homeless Programs' Outreach Project is due to it's staff, who is comprised of formerly homeless men and women; and WHEREAS, The Office of Homeless Programs' employees work in a high risk environment and it is necessary to provide these employees with support services; and WHEREAS, grant applications have been approved pursuant to the conditions contained therein, one of which stipulated that support services would be provided to all OHP employees from said grant awards; and CITY cobMSSION MEETING OF MAY 2 6 1998 Resolution No. 98- 495 WHEREAS, the Purchasing Department, in cooperation with the Office of Risk Management, solicited proposals from health care providers via AON Consulting, the City's insurance consultant; and WHEREAS, several health care providers responded as follows : CAC-Ramsey/United Healthcare of Florida, Inc., Humana, John Alden, Principal, United Healthcare, Inc., Prudential, and Foundation Health Systems; and the proposal submitted by Foundation Health Systems was determined to be the most cost effective and advantageous to meet the needs of the City's Office of Homeless Programs; and WHEREAS, additional funds will be required to cover anticipated new hires who are entitled to coverage; and WHEREAS, funding, in the amount of $45,000, will be sufficient to meet the present and future needs for employee health insurance coverage; and WHEREAS, funds for health insurance coverage are available from Account Code No. 183011.450392.6; NOW THEREFORE BE IT RESOLVED BY THE COMMISSION OF THE CITY OF MIAMI, FLORIDA: Section 1. The recitals and findings contained in the Preamble to this Resolution are hereby adopted by reference thereto and incorporated herein as if fully set forth in this Section. Section 2. The City Manager is hereby authorized' to execute a professional services agreement, in a form acceptable to the City Attorney, with Foundation Health Systems to provide health insurance coverage and benefits for the employees of the Office of Homeless Programs, for a period of one year, with the option to extend for an additional one (1) year period, in an annual amount not to exceed $45,000, allocating funds therefor from the Emergency Shelter Grant, Account Code No. 183011.450392.6.130. Section 3. This resolution will become effective immediately upon its adoption.. ' The herein authorization is further subject to compliance with all requirements that may be imposed by the City Attorney, including but not limited to those prescribed by applicable City Charter and Code provisions. 2 95- 495 PASSED AND ADOPTED this 2 6 thday of May , 1998. ATTEST: WALTER J. FOEMAN, CITY CLERK PREPARED AND APPROVED BY: RAFAEL O. DIAZ DEPUTY CITY AT RNEY Q CSK:W2512 AND CORRECTNESS: JOE CAROLLO, MAYOR 1n acc=Wce with Miami Code Sec- 2-36, since thMayorr di do Indic to aptionv l Of Ws fation by signing it in the designated place from the date of Commission action ernes ei#fective with the elapse of ten (10) days regarding same, Without the Mayor axe isi a to. Walter m ,City Clerk 98 - 495 TO FROM The Honorable Mayor and Members of the City Commission Jose Garcia -Pedrosa City Manager RECOMMENDATION: CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM CA-2 DATE : FILE May 8, 1998 SUBJECT: Resolution authorizing Health insurance coverage for REFERENCES: Employees of the Office of Homeless Programs ENCLOSURES: It is respectfully recommended that the City Commission adopt the attached resolution authorizing the City Manager to execute a Professional Service Agreement with Foundation Health Systems to provide health care service for the employees of the Office of Homeless Programs. The total yearly cost for said professional services is $45,000 with the option to renew for one additional year. The monies will be allocated from the Emergency Shelter Grant from the United States Department of Housing and Urban Development. The account and project code for this expenditure is 183011.450392.6.130 in the amount of $45,000. BACKGROUND: The Office of Homeless Programs (OHP) has received commendations from U.S. HUD and is considered a leader in the category of outreach, assessment and placement by the Miami -Dade County Homeless Trust and the Florida Coalition for the Homeless. The OHP outreach system involves cooperation and coordination with Miami -Dade County's Homeless Trust and Department of Human Resources, as well as the City of Miami's NET offices and Police Department. The Office of Homeless Programs employs and trains formerly homeless men and women and applies their experiences with homelessness to engage individuals and families living on the street. The OHP staff works in a high -risk environment�and it is necessary to provide them with affordable health care services. The Purchasing Department in cooperation with the Office of Risk Management, solicited written proposals from health care providers via AON Consulting, the City's insurance consultant. Seven health care providers responded as follows: CAC-Ramsey/United Healthcare of Florida, Inc., Humana, John Alden, Principal, United Healthcare Inc., Prudential, and Foundation Health Systems. Prudential's Mid Option Plan was the lowest proposal submitted ($38,311.48), however, their copayments are specifically higher for Hospitalization, Outpatient Surgery, Maternity, Mental Health and Substance Abuse services . The written proposal submitted by Foundation Health Systems,1340 Concord Terrace, Sunrise, FL 33323 for a total amount of $39,219.36 (exceeding Prudential's proposal by $888.00) offers the same benefits as Prudential's Mid Option Plan but has lower or no copayments; therefore it was determined to be the most cost-effective and advantageous to meet the needs of the employees of the City's Office of Homeless Programs. The total amount recommended for award ($45,000) exceeds the proposal amount ($39,219.36) by $5,780.64. This remainder will be applied towards insurance coverage for new hires. It is noted, current City policy and procedures for acquisition of a professional service requires the issuance of a formal RFP for contracts exceeding $50,000.00. ,;r- b. ,fir ,LCC'. 9 8- 495 CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM TO Joseph R. Pinon Assistant City Manager FROM : Livia Chamb_er Director Office of Horffelessd4x1grams. DATE i April 8, 1999 SUBJECT : Budget Approval REFERENCES: Health Insurance Coverage ENCLOSURES: FILE This division has verified with the Department of Management and Budget that funds are available for the purchase of Health Insurance Coverage from Foundation health Systems. Funding for this purchase in the amount of $45,000.00 is to be provided from the Emergency Shelter Grant account code no. 183011.450392.6.130. BUDGETERY REVIEW AND APPROVAL BY: LV.C-- 4& iipak Parekh, Director Office of Budget and Management Analysis LCGfjb 98- 495 0 City of Miami Office of the Homeless HMO Comparison Current Renewal PROPOSED CAC- CAC -United Humana John Alden Principal United CAC -United Prudential Foundation Ramsey/United Health Care Healthcare Plan 7:ype Basic-Lite Plan GroupCare Plan I Plan 2 Option 15 Neighborhood Classic HAfO Plan Choice GroupCare Plan if high Option Afid Option IL$f016 Health Partnership Option I CAC Afed Centers Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Out of Pocket Maximum hrdwidual $1500 $1500 $1500 $1500 $1000 $1500 $1500 Nomaximum $500 S1500 Ff $3 000 $3 000 $3,000 $3 000 $2 (M $3 000 S3 000 $1 250 $3 000 Primary Cart Physician Visit, No coM No co SS" $10c $5 covey $5 copay s10 $10copay S1Scopay SS co specialists No co No co No $IOw $5 copay $5 covey No co slow Si5co S5co Preventive Care Routine h •sicals No co No $5 co $10 co $5 No co - SIO" a Slo cu y $15 cops $5 co Routine child and well baby care. No copay No copay SS copay No copay $5 copay No copay SI0 copay $10 copay SI5 covey $5 copay immunizations Routine OYNCare 1 r •ear No copay No $5co y $10c St copay No -Pa $10 copay S10 co $15covey $5 covey Routine Eye Exam No copay No copay Optional Rider apprm Discount thin Vision NIA $5 copay S10 copay $10 copay SI5 copay $5 copay $2 single, $4 spouse, \Vorks family $640 Dental Hasic o tion Rider included Se me Polic • N!A NIA NIA Rider included NIA NIA NIA 11 sting Exam children thru age17 NIA $5 covey $10 copay $15 copay $5.00 Emergency Room No copay at CAC -Centers; No copay $5 copay $50 copay S35 copay S50 copay No copay S50 copay S50 copay $50 copay Other medical centers $25 ccpay Outpatient Su try No copay No covey No covey No copity No co $30 copay $50 covey No copay Maternity Op Visits initial visit onl • No copay No covey No copay S10 co $15 co $5 wp3y No copay S10 covey $15 co $5 copay lfospital No copay No copay No copay $250 copay No copay $100 admit $500 copay $250 copay $100 copay per day for No copay first 5 days Newborn Nursery Services No copay No o0pay No covey No copay No copay No copay No ocipay No covey No copay No copay No copay $50 copay $250 copay No copay $100 copay $500 copay $250 copay $ 100 copay per day for No copay Hos italization first 5 days Skilled Nursing Faulty ('are No copay No copay No copay 10(P.e for up to 120 days No copay limit 100 days No copay Not Mentioned I o o% up to too days per I WN, up to 100 days pet No copay: up to 100 r year per admission reuse cause des per year (tome Health Care No copay No copay $5 copay 100°S up to 60 pre- 100% up to 60 pre- No copay No copay 10090 1W,u (up to 60 visits Physician visits $10, authorized visits per year authorized visits per yew per year) Nurse & Therapists, No copay Hospice - Inpatient No copay No copay No copay If1(p e; lifetime max 190 No copay No copay No copay 100? o (up to a max of 100°'a (up to a Max of No copay days $7,400 in reasonable $7,400 in reasonable cash value per period of care cash value per period of care Ambulance for emergency condition No covey No covey No copay No covey No co $50 eopay No copiry No covey I No copy No co m Family Plannln a roductIve Services Consultation No copy No covey No copay slo w a $5 co $10 co N/A NIA $5 copay Sterilization Not mentioned No copay for diagnosis. Not mentioned 100%for tubal litigation No copay Limited to a $5 copay $10 copay for diagnosis. NA NIA $200 copay Treatment not covered or vasectomy(hospital S2,000 calendar year Treatment not covered copay applies if inpatient) maximum and a $6,000 lifetime maximum Infertility Treatment Not mentioned No copay for diagnosis. Not mentioned 10011e Lifetime max No ropey Limited to a SS copay; Diagnosis $10 copay for diagnosis. N/A NIA $5 coney for dingnosis: Treatment not covered $2,500 $2,000 calendar year Only Treatment not covered treatment not covered maximum and a $6,000 lifetime maximum Mental Health Inpatient No copay; max 30 inpatient No copay, mar 30 days No copay (max 30 days 100% e0cr inpatient co- No copay; 30 days per $100 admit; 30 day max No copay; max 30 days $250 wpay per $100 copay per day for No Charge days per year per year per year) payment per admission; year max per year confinement: max 30 first 5 days; (30 day max 30 da rear I Idays max Outpatient Noon Max 20 outpatient No copay; max 20 visits S5;(maxof20NisiIsperj 1004'° after $10 copay per $25 per visit; 20 visits S10 group: $2) Max 20 visits per year S20 "pay per visit; 20 $30 wpay per visit (max $10 Group'fherapy; $20 visits per year per year calendar year) visit; max $2," per year per year individual; 30 visit max visits per year or SI,000 20 visits per year or Pri. Therapy per visit r year max Sl 000 Subsranee Abuse Aon Consulting ivy r`f eaoau Off- of it, II —]— Page I 5'b5a City of Miami Office of the Homeless HMO Comparison Ztirrcnt Renewal PROPOSED CAC- Ramsey/United Health Care CAC -United Humana John Alden Principal United Healthcare CAC -United Prudential Foundation Pion Type Basic -Life Plan GroupCore Plan I Plan 2 Option 25 Neighborhood fleahh Panwersho Classic HAW Plan Choice GroupCore Plan H High Option bfid Option 11HO 16 Option I Inpatient No copay; max 30 inpatient days per year Not Covered 100% Delox only. Insurance pays 100% alter $250 covay No copay; 7 days per year max, 20 days lifetimemax $100 admit; 30 day max Detox same as any illness: max 30 days per 'ear $250 copay per confinement; 30 day max Delox only; $100 copay per day for first 5 days No Copay Outpatient No copay, Max 20 outpatient visits per year Not Covered IW1. (up to $35 per visit) 100°-e after $10 copay $2000 max per yeas Services must be covered by Ps ch/Caie Inc. $25 per visit; 20 visits per year $10 group; $20 individual; 30 visit max per year Max 30 visits per year $10 copay per visit; 30 visits per year max. $15 copay per visit (30 day max) S35 per visit ($2,500 max per year) Ember Dedsions Durable Medical Equipment Covered Covered IW/. Lifelime max $2,500 No copay Limited to a $2,000 calendar year maximum and a $6,000 lifetime maximum S50 copay Available 100°o up to max of $2,500 per year IOtpb max of $2,500 per year No copay Prescription Lens Reimbursement 1 per yaar Rider Included Discount ahh Vision Works NIA Rider Included N/A N/A N/A prescription Drugs S3/$8 $8 1717$10 $10copay SS/SIS $5 $8 $71$14 $I0I1.15 15:510 RATES: Employee 17 132.62 $164.03 S145.91 137.15 141.32 123.03 $130.88 $124.34 $126.19 Employee & Child ren 3 327.00 $311.65 S277.24 281.18 348.47 303,31 $239,51 $227.54 $239.75 Farrily 606.27 S524.87 1421.69 426.56 646.07 562,45 $418.82 $397.89 S403.80 Estimated bfoathl Premium $2 718.97 $3 941.81 $4 248.33 $3 733.88 $3 601.65 $4 093.92 $3 442.62 33 362.31 33 194.29 $3 268,28 Estimated Annual Premium $32 627.64 $46 101.72 $50 979,96 $44 806.56 $43 219.80 $49,121 W 141 111.44 S40,347.72 $38 331.48 $39 219.36 Good Thru 9115/98 Good thru 7/ V98 Good thru 6/1198 Good thin 6118198 Good Thu 9/15/98 Good Thu 9/15/98 Goal thru 8/1 /98 Good thru 811 //98 Dental See Attached No Dental No Dental No Dental Dental No Dental No Dental No Dental Vision Vision Plan Vision Plan Vision Plan S19conse 'CURRENT MONI'HI,Y PRBMRJM REFI.EC"fS 18 SINGLE AND 1 FANIU.Y UNIT VERSUS CURRENT' CENSUS PROVIDED TO US WIBCII INCLUDBS 17 SINGLE, 3 EMPLOYEE AND CI[R,D(RLN) AND 1 FAbRLY UNIT. CURRENT BENEFITS BASED ON INFORMATION PROVIDED BY CITY OF MIAMI -OFFICE OF THE I[OMBLESS Aon Consulting (lily of AUani office fthe Ilomelese Pete 2 V6,98 PROFESSIONAL SERVICES AGREEMENT AWARD SHEET PSA-97-98-004 ITEM: Health Insurance Coverage DEPARTMENT: Office of Homeless Programs TYPE OF PURCHASE: Contract Term for one year, with the option to renew for an additional one-year period RECOMMENDATION It is recommended that award be made to FOUNDATION HEALTH SYSTEMS, at a total annual amount not to exceed $45,000.00; allocating funds therefor from the Emergency Shelter Grant from the United States Department of Housing and Urban Development, Account Code No. 18 3011.450392.6.130. <h �(L I Dale ' — AwardPSA 98- 495,